Vice President of Value-Based Care Operations - Remote

Overview

The VP, VBC Operations will lead Pearl Health's efforts to ensure Medicare patients managed by our practice partners have appropriate benchmarks based on their condition. This critical role focuses on creating systems, developing vendor and internal capabilities, and strengthening client partnerships.

In Short

• Improve upon and excellently execute a comprehensive benchmark accuracy strategy for Traditional Medicare
• Create scalable, compliant processes that can adapt to changing regulations and practice needs
• Build programs that equip providers with actionable insights to improve diagnosis accuracy
• Partner with Pearl’s Customer Success team to drive provider engagement in benchmark accuracy initiatives through education and support
• Translate complex risk adjustment concepts into actionable guidance for clinical teams
• Partner with R&D, Finance, Actuarial, Data Science & Analytics and Customer Success teams on data-driven strategic prioritization and partner selection
• Coordinate with external vendors to enhance capabilities and fill strategic gaps
• Identify and implement technology solutions that aggregate claims, encounter, and clinical data
• Drive proactive condition identification through advanced analytics
• Ensure all activities adhere to CMS guidelines and documentation requirements

Requirements

• 7+ years of experience in healthcare operations, with significant focus on value-based care or risk adjustment initiatives a plus
• Proven track record of developing and scaling benchmark accuracy or risk adjustment programs
• Experience engaging with providers and health system leaders on clinical documentation improvement
• Deep understanding of regulatory and compliance requirements relevant to the above domains
• Demonstrable success in Traditional Medicare value-based models (MSSP, GPDC, ACO REACH, etc.); comparable experience in Medicare Advantage programs a plus

Benefits

• Annual discretionary bonus
• Equity options
• Remote work flexibility
• Supportive work environment
• Opportunities for professional growth